What have you read about MS and the Shingles Vaccine?

[Quixotic1]

My MS Neuro told me emphatically to get the shingles vaccine.  However, it is a live virus.  What have you read or heard about us getting the Shingles Vaccine and where did you read or hear about it?

[essdipity]

I agree that this is an interesting and important dilemma for MSers. Having had shingles myself around 15 years ago, I know for a fact how terribly painful it is. Imagine driving down the road with tears streaming from your eyes in reaction to the nerve pain.

(I think it's also thought-worthy that I contracted shingles after almost a year of great stress in my life, with the holiday season just coming. The damned virus had been lurking all my life, and attacked when I was very vulnerable.)

I certainly don't want another attack, which would be possible though improbable. But shingles or any wicked virus could also then set off an MS attack.

Yet so could the live vaccine. I'm inclined not to take the more immediate risk from the vaccine, because the odds just stack up that way for me.

Until better info or scientific assurance comes along, guess I'll keep my noggin buried in the sand.

ess

[Heather3418]

I asked my family doctor for the vaccine the other day during my routine visit.  She said that my insurance company would not cover the cost.  The vaccine costs $295.00 according to them.  Being on only Social Security Disability, that's hard to save up for, but I really think I need the vaccine for protection and really want to get it.

Am going to check with the local Health Department and see if I can get the vaccine there for free or at a much reduced cost.  Wondering how the "live" vaccine will affect my MS though, if it does at all.

Hope you all have a great week.  My prayers go out to all those affected by the nation's horrendous storms.  My heart goes out to all those affected.  What a nightmare.

[twopack]

No help with this from my MSologist.  He referred me to my PCP for an answer.

He tells me he's had questions about the wisdom of getting the shingles vaccine from about ten patients recently but he doesn't have an answer.  Says, "It doesn't come up at the MS meetings".  (What sort of meeting that is, I'm not sure.)

Let's see.  I'm asking about PwMS getting a specific vaccine.  They treat PwMS at this clinic, nothing else, just MS.  They are the experts.  I don't expect them to have the answer to EVERY question about my life with MS.  He just seemed a little too cavalier.  

So how come so many patients suspect this is important to ask about but he doesn't make an effort to get us some answers?  Today wasn't his most shining day as a practitioner.  Luckily I have an appointment with my PCP in two days and have great trust in her answers.

Mary

[twopack]

Anybody know of any concrete info that came from this discussion?  I have an appointment with my MSologost Monday and will get his opinion but, like Quix, I'm interested in recommendations from reputable sources.

I wonder how this vaccine works?  It's a live vaccine but the only people getting it already have the virus lying dormant in nerve tissue (most likely trigeminal or dorsal root ganglion).  So it can boost immunity without activating the dormant viral load?

I'll be meeting the age criteria soon to get the vaccine so need to consider carefully.  With recent cranial nerve symptoms abounding I don't really need any additional TN problems from VZV.  I have time to consider since I haven't been off steroids a week yet.  Then I'm wondering if I would need to go off Nasonex too since its a steroid based nasal spray.

It's very tempting to jump at the possibility of preventing shingles but very hard to get past the possibility I could end up with regret.

Mary

[Quixotic1]

recommendations re: getting the vaccine from reputable sources

[sllowe]

Doc Q - are you looking for incidents of vaccinated MSers and subsequent attacks, or just some specific documented recommendations, or studies, or something related?

I don't mind digging for a needle in the haystack - just need the angle.

-shell

[HVAC]

Good to know about steroids. My Neurologist wanted me to get the vaccine and my PCP said no. I guess the asthma explains it. I have a friend with MS who keeps getting shingles no fun.

[Quixotic1]

And - as we know - the DMDs are NOT immune-suppressive therapy!

BTW - Yes, steroids would be s significant contraindication.  The varicella virus goes wild in the presence of steroids.  One of my partners had a child die of chickenpox while on a moderate dose of steroids for asthma.

q

[rendean]

Specifically in the CDC article;Rarely, patients will experience acute focal neurologic deficits weeks to months after resolution of the zoster rash, involving the trigeminal distribution contralateral to the initial rash. This ischemic stroke syndrome, termed granulomatous angiitis, is believed to be caused by direct extension of VZV from the trigeminal ganglion to the internal carotid artery or its branches, resulting in inflammation (30). Mortality from this syndrome is substantial. Other rare neurologic complications of zoster include myelitis, aseptic meningitis, and meningoencephalitis. The prognosis for these conditions is good, although encephalomyelitis can be life threatening. Guillain-Barré syndrome also has been reported in association with zoster (47)

The most ominous thing  I found with a breif search on PubMed.

[rendean]

I found these 3 articles relating to the vaccine and they do NOT mention MS. They do mention  steroids (prednisone 20mg or less /daily ) as a contraindication. Surprising since it is a live virus. Perhaps, your doc feels you're at increased risk due to many years of exposure as a pediatrician. I mostly skimmed these articles but they talk about "wild VZ" versus other  types. Regardless, the consensus was , if you have actually had a cause of chicken pox then you should get the vaccine unless you are specifically on an immune-suppression therapy.


http://www.webmd.com/skin-problems-and-treatments/shingles/shingles-vaccine?page=2

http://foodconsumer.org/7777/8888/D_rug_N_ews_50/051503272008_CDC_recommends_shingles_vaccination.shtml

http://74.125.47.132/search?q=cache:KvmUbOTY8QQJ:www.cdc.gov/mmwr/preview/mmwrhtml/rr57e0515a1.htm+contraindication+to+shingles+vaccine+in+multiple+sclerosis&cd=1&hl=en&ct=clnk&gl=us